Back Aches - For What It's Worth

From time to time I encounter people who have back problems of one sort or another. Having such a history myself I am inclined to get into a conversation about what might be done.  A few days ago, after such an encounter, I was inspired to write the following so I could just hand it out and save on talking.

 
I once was very free with advice about back aches, thinking what I had learned from my own experiences would be useful to others.  I’m more modest now in this regard because I now think there are many different sorts of back problems so not all advice is applicable.  That said, what follows is the best wisdom gathered from a 15 to 20 year saga of recurring, incapacitating back spasms.  I hated it when my wife said that I had a bad back meaning a back predisposed to injury.  What I think I had was a perfectly normal back that I mistreated often enough that I would have 2 or 3 episodes a year when for several days I was barely able move off the ground or out of bed.  That was roughly between the ages of 25 to 45.  The incidence of trouble started going down in my early 40’s mostly due to my learning what particular acts or activity put me in jeopardy.  Once I learned what not to do or at least how to be careful, the problem went away.  In my early 50’s, for reasons other than my back, I started getting more exercise which strengthened my back so that now at age 75 I can do much more than I could at 25 without hurting myself.  The following can be read as advice, but as stated above, it ain’t necessarily right.

 

In the case of an acute situation my first goal is to end the pain.  My back aches occurred in my lower back where there are many small cooperative muscles.  If one spasmed the pain would cause the adjacent muscles to grow tense and vulnerable and interfere with the recovery of the sore muscle.  Of course stopping the pain was useful in its own right.  For me step one is to take the strongest pain medicine available.    There may also be some body positions that reduce or eliminate pain.  One such position for me was lying on my back on the floor with my lower legs laid over the seat of a side chair.  My thighs were vertical at the hip and my legs bent at the knees so the calves could rest on the seat of the chair.  Once on a trip to Central America I spent a night like that.  In the morning I was ready to go.  Another tip for comfortable sleeping is to sleep on a slippery surface such a nylon sleeping bag wearing some kind of slippery shorts.  Thus bed friction is minimized.  Before I got onto these friction reducing measures I would from time to time exacerbate an injury in my sleep by trying to drag my hips/pelvis to some new position.  After stopping the pain as much as possible step two is to get the right amount of exercise.  The problem of course is knowing what is the right amount.  I do think exercise is therapeutic.  At the same time it is easy, once one is feeling better, to do too much and suffer a setback.  So move and exercise the injured area, but err on the side of too little.

 

There are two or three things to do that could be thought of as long run strategies.  One is to think very hard about any particular back incident that may occur.  What was the immediate cause and was there any lead up to the immediate cause?  For example I could shovel dirt or snow all day without incident, but then, on the next day, I might easily incur a back spasm by picking up a sock.   The muscles, tired from the shoveling, were vulnerable to the slightest stress.  Eventually I learned to be careful on days following shoveling.  As is well known, improving one’s fitness, especially core strength, can pay off in fewer back problems.  For reasons unrelated to my back, in my fifties I became much more fit.  Now at age 75 I can stress my back much more than I could at age 25 without suffering bad consequences.  And finally recalling my first advice for an acute attack, i.e. stop the pain, I always retain any pain medicine that is prescribed for me, but which I don’t initially need.  It can come in handy.

The Longest Life - A specculation

I've just awakened from a dream in which I briefly saw and spoke with my father-in-law who passed away about 40 years ago.  He was delivering some groceries to our kitchen.  It must have been summer with the door open so he could walk right into the house and announce himself with the family whistle.  I believe my mother-in-law was along, but I woke up before she made her appearance.  It was a very pleasant dream.

It won't be too much longer until all who knew Rodge will be gone and he will not even appear in a dream.  Puccini on the other hand is different.  About a year ago I went to La Boehme.  When it was over I thought with some amazement that Mr. Puccini, now dead for some long time, was still thrilling audiences, myself included.  Of course he had a lot of help.  Those who invented the musical form, and the instruments.  Those who made themselves able to perform what Puccini created.  Those who care to listen to his music.When there are none of these then I suppose Mr P will at last be effectively gone as well.  But it's a nice run he's having.

Such thoughts of course lead to the question of who will live the longest in the sense of being remembered and relevant.  I wonder if Thomas Edison is as well known in the rest of the world as he is in the U.S.  The electric light is a pretty big deal I think.  But do young people today, even in the U.S., know of him.  I'll have to ask a few.  There are the political inventors and creators.  T. Jefferson and friends come to mind along with Hobbs and Locke, etc.  Their work seems like it will impact people for a long time to come.  But I guess it is the religious guys who take the cake and among those is there any older than Abraham?  More than 4,00 years and people still find solace and hope and rapture and hate and reasons to kill one another as a result of his work.  I guess that's the record.

Karma Among Some Antiquities

I suppose it was because I turned down his money that he offered an eight inch stack of vinals topped by Crosby, Stills and Nash.  Someone had given them to him and he didn't really have a use.  I didn't either.  I had to think if we still had a turntable or if we had given it to the Goodwill.  They were sitting there in the trunk of his 70's something muscle car when he opened it to get out his bike rack which he needed to carry home the late 40's girls Schwin that I had just returned to him though I had never seen him prior to his arrival at my door ten minutes earlier.

It was quite a cool bike, with its fat tires and coaster brake.  Of course the chain and wheel rims were still pretty rusty.  I hadn't cleaned them in the six or ten months or whatever since the afternoon I had pedaled past it standing somewhat forlornly on that curb in Wallingford, next to a recycle bin, waiting, I surmised, for a trip the next day to some scrap metal melting pot on the industrial side of  town.  I'm sure I would never have stopped to beg for its life had the woman not been standing right there doing something to her lawn.  Well, that's putting a little edge on it.  All I did really, was ask.  The woman was happy to give it up along with a little, slightly prideful, mention of its history at Burning Man  http://www.burningman.com/whatisburningman/.  The corroded chrome on the handlebars  and squiggly hand painted markings on the fenders lent credibility to her claim.  I reflected, a little sadly, on what the passing of a few years and living in a nice bungalow in a yuppie neighborhood could do to a one time sojourner in the Nevada desert in late August.  But who am I to judge.  My first trip to Burning Man still lies before me.  So I went back later with my minivan and fetched the bike home. 

I can't recall if my ultimate use for it was already formed in my mind or if I was just grabbing a somewhat classic velocipede.  In any case I did use it, along with a couple like models, to advertise a condominium we wanted to sell.  Now, the condo itself is a classic.  Built in 1929, it features leaded stained glass windows, coved ceilings, and a sweet faux fireplace with colored glass coals shimmering on a grate over an electric bulb. Distaining the services of professional realtors, I created a website describing the property, and on my vintage bicycles I placed signage inviting interested passers by to the website.  Then I put the bikes out on the street and in some parks where I thought there might be potential buyers.  Every few days I moved them around.

That's where he saw it - the beloved conveyance he had taken to Burning Man six times and planned to take a seventh, until his landlady, thinking it was worn out, put it out for the recycle guys.  That irretrievably hopeless loss months prior was suddenly standing there beside his route with a sign on it - Oh how convenient! - telling how to contact the guy with the key to the lock thereon.  And so he called this PM and offered money for his bike.  And the final lovely coincidence is that just four days earlier we had signed the purchase and sale agreement for the condo, that brought to an end the brief, but successful advertising career of a certain late forties, blue girls' Schwin.

I think I'll go put on a little Crosby, Stills and Nash, eat some brownies and try to remember 1972.  It's legal now in Washington you know,

25th Anniversary Ride: A Cycling Memoir

.Reader Warning: The paragraphs below set a new high in self indulgence in a blog that is chock-a-block full of boasting and ill edited blather.  I hope you will read them, but I'm sure you have better things to do.  This post is mostly for my great grandchildren should there be any.

Twenty five years ago I marked my 50th birthday by joining some 2,000 others in a bike ride from Seattle to Portland OR.  At the time I thought 50 was an advanced age for riding such a distance, although there were, even then, some who had done the ride at ages into their 70's.  I  think it is now more or less routine to have 70 year olds.  Anyway, I thought I was kind of old.  What I didn't know was that I was just getting started as a somewhat serious bike rider.  In the years since, I have done the ride 5 more times,  so this year will by my 7th, if I complete it.  I have also done a couple of multi-week rides in the U.S., ridden in Europe, Hawaii, New York City, and California, led thematic rides around Seattle, ridden around Mt. Rainier (The Ramrod) and used a bike as my most common means of travel around Seattle. The rudest thing I've done on a bike is ride naked in the Fremont neighborhood Solstice Day Parade.   This weekend about 10,000 people will do the STP (Seattle to Portland).  About 20% of them will do the 200 miles in one day.  I suspect I will be the only one  carrying a snail in a jar dangling in front of me as a pace setter.  While most STP riders take the event rather seriously, riding as fast as they can on the best machines they can afford, I've always chosen to be a bit silly.

This time I'll be riding the same 5 speed, mid seventies, Schwinn, girls bike that I rode that first year.  It was given to me when it failed to sell at a garage sale.  There is attached to the sides the same cardboard cutout of a dinosaur.  Dino has been resting for the last 2 and 1/2 decades in my attic, awaiting his comeback appearance.  This is it.  My second STP was begun on a three wheeled rowing machine, though that proved to be too slow so the second day I resorted to the Schwinn again.  I did get my picture on the front page of the Seattle Times sports section that year.  The next two outings, a few years later, were done on a 1963 collapsible bike (an early Alex Moulton, for any cognoscenti, who may be reading) that I bought in a mountain town in Guatemala.  It was equipped with a three speed hub.  The second of those years I dressed as a sailor and carried signage advertising  a production of Gilbert and Sullivan's H.M.S. Pinafore.  In 1997 I did the ride wearing a tuxedo and pulling a mannequin dressed in a formal gown on a trailer bike. I called that "Styling To Portland." My last time, in 2001, I wore cowboy boots, and a neckerchief.  A horse skull was mounted on  the handle bars and a tail swung behind the seat, which incidentally, earnest bike enthusiasts always call a saddle.  That year I did the ride in one day. 

If all goes well, in two days I will roll into Portland in time for dinner.  If I'm lucky my sister-in-law and riding companion will sing to me for the last ten miles.

Maintaining (and expanding) Our Cultural Heritage

I see that back in November I had a post musing about what to do with my prostate cancer diagnosis.  The update is that in early April I underwent a radioactive seed implant procedure.  That episode underlies the current post.

I expect that it is in junior high that 7th grade boys teach 6th grade boys a little poem.  In fact it may be part of the formal curriculum.  Actually it probably predates middle school by an unknown number of centuries. Girls have to wait until they form a close bond with a boy before they hear it.  It goes like this.

No matter how you shake and dance,
The last three drops get in your pants.

I find that modern medicine has created a parallel rhyme for at least a subset of older males.  Here it is.

No matter how you shout or pout,
The last three drops just won't come out.

The Case For Income Redistribution

When we lived in Guatemala many years ago I used to see a car with a bumper sticker that read, "Taxation Is Theft".  Apparently the owner was a person whose belief in property rights trumped everything. 

Hypothesis I:  There is a God and it cares about property rights.  If this is the case then one needs only to seek revelation, either one's own or someone else's.  I leave the search for such revelation to the reader who accepts this hypothesis.

Hypothesis II:  Either there is no caring God or if there is, it doesn't care about property rights.  This is a far more interesting hypothesis as it allows for thought and discussion of the topic.  By income redistribution I mean government policies and acts that redistribute between citizen groups.  Any given policy would occupy a point along a continuum running from unfettered private individual ownership of everything to collective ownership of everything. It is not my intention to identify any such point, but merely to justify government actions intended to move a society along the spectrum in the direction of collectivism. 

First the other side,  There are strong arguments for private individualized ownership of stuff.  They have to do with incentives.  If you get to keep the fruits of your labor or innovation there is much more incentive to work hard and or innovate, than if what you generate is shared equally among all. The same applies to the husbanding of resources.  There is little reason to not shoot the last pair of mating buffalo if, because they are commonly owned, someone else will.  The absence of defined and enforceable property rights in the air, the oceans, etc. can be seen as a major factor in the abuse of these resources.

And finally we arrive at my point.  What right has society collectively to take any disproportionate share of Bill Gates wealth from him and pass it on go someone else?  If it was legally earned by creating big social benefits, how do we slackers who created less and earned less get off taking away some of his?  And my answer is, because he did not gain this wealth individually. He was able to gain it because he was embedded in a society of people.  If her were not, if he lived and worked alone, though he might have physical control over all of North America,  he could not live at much more than a subsistence level.  He may have contributed enormously to the group, but he also gained enormously from being in the group.  That is the ethical reason why he may be taxed more heavily than others.

P.S.

I see that, measured in paragraphs, the introduction is four times longer than the sole point.

Counter Cyclical Fiscal Policy, National Debt, and the Role of Government

This is a pretty long and pedantic post.  Nobody should undertake to read it unless he or she happens to want the thoughts of an out of date student of economics.

The discussion of the deficit and national debt that has been going on in Washington DC has conflated the title elements of this post to the detriment of the discourse.  Hopefully the important players know very well all that lies below, but they make precious little effort to display such understanding or to try to educate their constituents.  So here's a shot at getting some things straight.

The government is not like an individual.  If you hear someone say it is, watch out.  The speakereither is trying to deceive you or just doesn't know what he or she is talking about.  The most important difference for this discussion is that whereas an individual's earning stream is limited to something like 50 years at most, the future income stream for a government is essentially unlimited.  100 years from now the government will probably still be here and it will still be collecting taxes. That is a real difference from individuals and what it means is that while an individual has to balance his spending and earning over a term of about 50 years a government does not.  In this way a government is much closer to a corporation than to an individual. It is fairly difficult for a person of 65 to find a bank that is willing to make a 30 year loan since the borrower's income stream, and indeed his life, is unlikely to go on for 30 more years.  A more or less immortal government or corporation has no such constraint.  Furthermore for a corporation to be continuously in debt for 100 years is not necessarily a sign of weakness. It could be a sign of strength; a sign that lenders have  continuously viewed it as a safe bet.

There is no right answer to the question "Is debt bad?"  Much depends upon what is to be done with the borrowed funds.  Here a government is more like an individual.  Borrowing  to invest in something that will increase productivity may be extremely wise.  For a government it might be a highway, or a vaccine.  For an individual borrowing to finance higher education or the tools of a trade can pay off well.  Borrowing to go on vacation on the other hand clearly lacks the same justification.  A government equivalent might be Amtrak subsidies or food stamps or health care for retired people.  I think most government expenditures go to things the sponsors can argue will benefit future generations.  Those who are troubled by our national debt bemoan the burdens we are placing on our progeny.  But think about this.  If we borrow some money from China and use the funds to provide a better education, or highway system or renewable fuel source for our children to live with and use, have we done them wrong?  I don't think it is obvious.  Though they may have to pay back the debt they may well have a higher level of production out of which to make the payment. Borrowing to finance a war that preserves a nation may not be so bad for those who come later.  The basic point is that the virtue or vice of debt depends to large degree on how the borrowed money is used.

Perhaps the most powerful truth in economics is that specialization in production beats generalization.  No individual, no matter how talented or how endowed with resources can, working alone, provide for himself the necessities and comforts of life that the humblest workers enjoy in even a modestly specialized economy.  But specialization in work requires trade which in turns implies interdependence.  The more specialization and trade that takes place, the more bounty and the more interdependence there is.  At some point a couple of hundred years ago specialized, interdependent economies reached the place where they became subject to periodic  breakdowns; dislocations that left resources, especially labor unemployed.  If resources are left unemployed total output is less than it might have been.  There are less goods available to satisfy the people's wants.  This shortage is disproportionately borne by the unemployed.

Counter cyclical fiscal policy refers to governmental taxing and spending activities designed to dampen the variation in economic activity.  One reason for a modern economy to go into a slump is a lack of demand for the stuff that workers produce, and falling demand has a self reinforcing aspect.  Stuff builds up on retail shelves.  Orders go down.  Workers get laid off.  Having lost their income they buy less and more stuff builds up on the shelves.  Government spending adds to general demand for the output of the economy.  Taxing is thought to reduce demand by drawing purchasing power from the hands of consumers.  Therefore deficit budgets, those with expenditures greater than taxes, are considered to be stimulating.  Conversely surplus budgets are thought to dampen economic activity.  In other words in periods of high unemployment counter cyclical fiscal policy consists of running deficits, i.e. increasing the national debt.  If fiscal policy is in fact efficacious then an economic downturn is no time to reduce the national debt.  Debt reduction should be done when the economy is piping along and perhaps needing some cooling down. 

It must be said that not all economists believe that fiscal policy works as described above.   But what ought to be understood is that the efficacy of fiscal policy is a question of fact not of choice.  The answer should be the same for a big government lefty or a small government loving righty.  It doesn't have to do with the desirable size and role of government.  It has to do with how market economies work.  It is really a shame that the study of the workings of a market economy is so difficult that this fundamental question is not well resolved.   There is one big historical example that makes it look like fiscal policy does work.  By 1938 there had been some recovery from the depression of the previous nine years.  The Congress and FDR agreed to some tax increases and spending cuts to get the federal budget nearer to balance.  It seemed prudent.  What followed was a downturn in the pace of economic activity.  That's half the example.  The other half is that starting three years later a really big war was financed with really big deficits and simultaneously the economy became robust.  Does fiscal policy work?  It certainly seemed to in that instance. 

It is also notable that what was produced in this greatest of all deficit periods was not productive assets for future generations.  We built a ton of stuff that was then destroyed.  Except for the fact that a political system we are fond of was saved, the exercise was really an example of over consumption done at the expense of future generations.  We were not creating a lot of infrastructure or manufacturing capacity that would enhance the lives of those who came later.

The capacity to borrow means that there is not a one to one link between raising money and spending money.  That makes counter cyclical fiscal policy possible, and to the extent counter cyclical fiscal policy is efficacious, it is a good thing.  However the loose link between taxing and spending has other results that may not be so good.  In particular unhooking spending and taxing allows government to hide the cost of its activities.  If you have a government activity that you don't want people to feel the cost of providing be it a war or a subsidy for the arts, then pay for it with debt.

There is an independent, hard headed, self interested indicator of whether or not the  nation's debt is too large.  It is one that should be particularly appealing to those who revere private markets.  It is the interest that lenders demand in order to hold the debt issued by the government in question.  If the U.S. were borrowing too much and using its borrowing capacity frivolously rather than prudentially, then the cost of borrowing should go up.  It should go up proportionately to the ill advised behavior.  I'm not aware of any such paucity of would-be lenders to the U.S. Government.  In fact U.S. government debt is regarded as one of the safest investments to be found.  When the U.S. credit rating was reduced a while back it was due to Congressional threat to default on the debt by not raising our totally arbitrary debt ceiling.  We were basically threatening lenders that we might not pay our bills.  Not that we couldn't, but that we wouldn't.  The financial markets don't seem to be all that worried about the debt at the present time.

What is a matter of choice and judgment is the size and role of government.  I don't believe there is anything wrong or stupid about thinking that government is inefficient, corruptible, or potentially despotic.  I personally believe there are lots of important ways that markets fail including imperfectly defined property rights, unenforceable property rights, corruption and perverse income distributions.  It is through the government that we might solve such problems collectively.  People who believe otherwise are not prima fascia stupid, or evil.  Whatever amount of government we choose to have, we should pay for.  However we should probably not work on balancing the budget during periods when the economy is weak.